Project Abstract This is a competing renewal application for the New England Consortium Node (NECN). The NECN, led by Kathleen Carroll, PhD, of Yale, and Roger Weiss, MD, of Harvard, has a track record of outstanding productivity in the Clinical Trials Network (CTN), with leadership of 4 highly successful completed trials, high levels of study participation, excellent recruitment and retention, and 38 peer-reviewed CTN publications during the current funding period. NECN investigators have published the 3 most widely cited papers in the history of the CTN and are currently leading 6 CTN trials. With the recent CTN emphasis on SUD research in general health settings, we have added a third PI, Gail D?Onofrio, MD, currently leading 2 large CTN trials in emergency departments (EDs). The primary aims of this competing renewal application are to: 1) Continue to extend the NECN?s strong clinical research infrastructure into an even wider range of healthcare settings, and 2) Propose a series of studies in an array of healthcare settings to improve interventions for a wide variety of people who use substances, ranging from those with risky substance use to severe substance use disorders (SUDs). These studies, building on previous work of NECN investigators, address critical issues that face practitioners throughout the healthcare system. Proposed studies include the following: 1. Screening, Brief Intervention and Referral to Treatment (SBIRT) vs. SBI with Onsite Computer-based CBT for Stimulant Use Disorder in Primary Care 2. A Randomized Controlled Trial to Prevent or Reduce Substance Use by Youths with Chronic Illness 3. Testing an evidence-based psychosocial treatment for stimulant use disorder and concurrent HIV sexual risk among men who have sex with men 4. Implementation of the Addiction ?Bridge Clinic? Model for General Medical Settings The NECN can provide clinical research access to virtually any substance use population and setting, including primary and specialty care for children and adults, medical and emergency care, medical/surgical hospitalization, psychiatric treatment, and SUD specialty care. Our Node has developed state-of-the-art health information technologies that can be leveraged for CTN studies. The NECN has the ideal mixture of cutting- edge investigators, including national leaders in addiction medicine and specialty care; superb, research- friendly clinical sites; and a track record of innovation, leadership, collaboration, and outstanding productivity in the CTN. We have demonstrated our ability to conduct cost-efficient pragmatic trials of treatments that have directly improved clinical practice. We have the scientific expertise and the clinical and research infrastructure to play key roles in a variety of SUD studies in both general healthcare facilities and specialty SUD treatment programs. We are well prepared to continue to play a key role in all aspects of the CTN.